Becker's Clinical Quality & Infection Control

28 PATIENT SAFETY ECRI Institute's 10 Top Patient Safety Concerns By Heather Punke P atient identification problems, the mismanagement of behavioral health issues and measurement-related med- ication errors appear on this year's edition of ECRI Institute's "Top 10 Patient Safety Concerns for Healthcare Organizations." For the 2016 report, published in April, ECRI Institute looked into its own database of reported safety events, consulted literature and asked experts for their opinion on what to include. e resulting list is of "real things that are happening," said Catherine Pusey, RN, associate director of ECRI Institute Patient Safety Organization. "ey're happening at a serious level." e following are ECRI Institute's 10 picks for the top patient safety concerns of this year. 1. Health IT configurations and organization- al workflow that don't support each other 2. Patient identification errors 3. Inadequate management of behavioral health issues 4. Inadequate cleaning and disinfection of flexible endoscopes 5. Inadequate test result reporting and follow-up 6. Inadequate monitoring for respiratory depression in patients on opioids 7. Medication errors related to pounds and kilograms 8. Unintentional retained objects during surgery even with correct count 9. Inadequate antimicrobial stewardship 10. Failure to embrace a culture of safety Visit www.ecri.org to get a full copy of the report. n WHO Issues New Hepatitis C Infection Treatment Guidelines By Heather Punke I n April, the World Health Organiza- tion updated its guidelines for hepa- titis C infection treatment, which were originally released in 2014, because of the rapid development hepatitis C medications and treatments in the last two years. New direct-acting antiviral medications are more effective than previous treat- ments, as they are short in duration, easy to take, have few side effects and cure more than 90 percent of the people tak- ing them, according to WHO. "This is a vast improvement from older treatments, which cured less than half of the people treated, required weekly interferon injections for up to 12 months, and often resulted in severe, sometimes fatal, side effects," according to WHO. Even though these new drugs are highly effective, their prices vary dramatically in different countries, so WHO recognizes that implementation of the new guide- lines may not be immediate. n Researchers Say Current Hepatitis C Testing Guidelines Overlook Many Cases By Max Green U p to a quarter of all cases of hepatitis C virus infection cases may be overlooked due to overly lax federal screening guidelines, a study in Clinical Infec- tious Diseases suggests. Current CDC recommendations state that those born between 1945 and 1965 and those with risk factors like injection drug use should be tested for the virus at least once. But when Johns Hopkins Hospital's emergency department ran the number of cases it detected using its expand- ed screening protocol, which tests all adults over 18 for HCV, against federal guidelines, it found nearly a third of those who tested positive were unaware they were infected. These patients would not have been tested had the hospital only followed the federal guidelines. "Hepatitis C has a very long clinical arc, so if you get infected, you may not have obvious signs of illness for five to 10 years," Thomas C. Quinn, MD, senior study author and professor at the Johns Hopkins University School of Medicine, said in a statement. "This is an infection that can now be cured if detected early, rendering people nonin- fectious and thereby preventing the dire consequences that are associated with the virus. However, we found a large proportion of undocumented, undiagnosed hep- atitis C infection in the population attending this ED." Universal testing is advantageous because many people with risk fac- tors, such as those from injection drug use, don't readily disclose their risk to clinicians, according to the authors. They concluded that had they not expanded their ED guidelines beyond those recom- mended by the CDC, 51 HCV-pos- itive patients would have gone undocumented. n

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